Hydrops (Swelling) of the Gallbladder
Acute swelling of the gallbladder in the absence of gallstones is a well-recognized problem. Hydrops may occur as a newborn and in older children. This condition is characterized by the development of a fluid collection around the gallbladder and main bile duct that drains the liver. Older infants and children may have a fever, a lump one can feel in the right upper part of the abdomen, and tenderness when the abdomen is examined. Sometimes a lump one can feel may be the only finding in babies. In newborns, acute gallbladder swelling has been observed in babies who have a general infection and has also occurred in patients born with congenital blockage of the duct that drains the gallbladder. In older infants and children, hydrops may accompany diseases such as scarlet fever, leptospirosis, Kawasaki disease and others. The diagnosis usually is made by abdominal ultrasound. Treatment may include antibiotics if an infection is suspected, and allowing the child to eat if possible as this stimulates gallbladder to squeeze and drain bile. Hydrops should be followed by ultrasound examinations. If the gallbladder remains swollen and pain persists or increases, a cholecystostomy (placing a drainage tube in the gallbladder) may be performed to temporarily reduce the swelling. If the gallbladder tissue appears to have died or if there is blockage to the duct draining the gallbladder, a cholecystectomy (removal of the gallbladder) should be performed.
Article and graphics adapted from O'Neill: Principles of Pediatric Surgery. © 2003, Elsevier.